By: Stanton A. Glantz, PhD

Editorial

Journal of Public Health Management and Practice, January 1999 (Vol. 5. No. 1.)

(References and formatting edited for the Internet)

THE STORY has become tediously familiar: a concerned legislator or group of citizens decides that it is time to pass a local clean indoor air ordinance to protect the public and workers from the toxins in secondhand tobacco smoke. After mustering the scientific evidence that secondhand smoke causes heart disease, cancer, sudden infant death, asthma, and a variety of other problems, public health advocates approach the city council or other legislative body to act. Shortly thereafter, a concerned restaurant association sidesteps the issue that secondhand smoke is dangerous and produces a "study" claiming that the result will be economic chaos, with 20-40 percent drops in restaurant business. As time passes, local tobacco control advocates or the media force the restaurant association to admit that it "requested and received some support." Often, it ultimately comes out that the tobacco industry or one of its public relations firms' organized the "restaurant association" (Figure 1). After a long debate, the ordinance passes.

After Glantz and Smith published their study demonstrating that smoke-free restaurant ordinances have no effect on restaurant revenues in the first 15 cities to pass such ordinances, the tobacco industry's claims of economic chaos lost credibility, particularly in California and Colorado, where the cities were located. While this study was also useful to advocates in other states (including those in New York and Massachusetts), the industry started to argue that there was something unique about California or Colorado and, while there might not have been economic chaos there, it would happen elsewhere The articles in this issue of the journal of Public Health Management arid Practice (JPHMP) show that, in contrast to claims by the tobacco industry, smoke-tree restaurant ordinances have had no impact on revenues after New York City and several communities in Massachusetts passed such ordinances.

With the addition of the articles in this issue of JPHMP, there are now published data on the economic impact of smoking restrictions on restaurant sales for 81 localities in six states, 67 of which are 100 percent smoke-free in restaurants (Appendix 1). While there are some differences in the ordinances and the methods used to study them across localities, all have relied on objective sales tax data to assess economic impact. The sales tax data from these 81 localities are consistent in demonstrating that ordinances restricting smoking in restaurants have no effect on revenues.

Studies of economic impact based on sales tax revenues have several advantages. First, and most important, the data are objective. They are collected by tax authorities with no interest in the impact of a clean indoor air ordinance. Second, they are complete; they include all restaurants. Th ird, they are available over time, so it is possible to adjust for underlying economic trends or seasonal variability. The problem with studies of the impact of clean indoor air ordinances based on sales tax data is that they are not available until well after an ordinance passes. Thus, when confronted with predictions of disaster based on industry-inspired Surveys of the city in question, advocates can only point to evidence from other cities.

The appropriate response to such predictions from the tobacco industry and its allies and front groups is to point out that these claims have been made everywhere else and, when the objective data became available a year or two later, they turned out to be wrong.

Faced with the growing evidence that restaurant ordinances do not affect revenues, the tobacco industry has fallen back on a series of secondary claims, that the public will not comply with the ordinance or that it will somehow hurt employment or tourism (even though revenues are not affected). Other articles in this issue of JPHMP also debunk these claims. Indeed, New York City added restaurant jobs faster than the rest of the state after the ordinance went into effect. As already demonstrated in other places, the public supports and complies with these ordinances.

These results are not surprising, given growing public awareness of the dangers of secondhand smoke. Indeed, despite a major public relations campaign designed to undermine it, the public supports and complies with California's smoke-free bar law, which went into effect on January 1, 1998. A June 1998 statewide poll conducted by the nonpartisan Field Institute showed that 85 percent of bar patrons go to bars as much or more than they did before the ordinance. At the same time, local health departments reported that compliance is good (90% in restaurant-bar combinations and 70% in stand-alone bars), and is improving over time."

The tobacco industry has created "restaurant associations" since the early 1980s, when it created the Beverly Hills Restaurant Association for purposes of seeking a repeal of Beverly Hills' clean indoor air ordinance. As documented in the history of how the New York ordinance passed, the industry is continuing this strategy. Public health advocates should investigate carefully the bona fides of "restaurant" or "business" groups that suddenly appear wilting to spend large amounts of money opposing tobacco control ordinances, with reasonable sounding names like the California Business and Restaurant Alliance or the San Diego Tavern and Restaurant Association (Figure 1). In addition, since the industry now knows that public health advocates are looking for this tactic, it may be, moving to work through legitimate restaurant organizations, perhaps by funding their efforts or directly or indirectly underwriting their lobbying expenses. Public health advocates should demand that any organization that opposes a local clean indoor air ordinance disclose fully its involvement with the tobacco industry or its public relations, apparatus.

The articles in this issue of JPHMP confirm that continuing local activity to pass clean indoor air ordinances tailored to meet local conditions is the best way to protect nonsmokers from secondhand tobacco smoke." Aware of this fact, it is particularly important that public health advocates defeat efforts by the tobacco industry to enact weak state legislation preempting the ability of local communities to enact tobacco control ordinances.

The real reason that the tobacco industry opposes these ordinances is that the creation of smoke-free restaurants represents a strong message that smoking around other people is no longer socially acceptable. Creating smoke-free workplaces reduces cigarette consumption. This changing social environment will help people quit smoking and reduce tobacco industry sales and profits. For example, Glasgow et al. estimate that if all workplaces in the United States were smoke-free, an additional 178,000 smokers would stop smoking, and, among those who continued to smoke, they would consume 10 billion fewer cigarettes per year. There is simply no other tobacco control intervention that can contribute this much to public health this quickly — for both nonsmokers and people who would like to quit as creating smoke-free environments. The battle over clean indoor air in restaurants has become symbolic for the whole battle over clean indoor air.

In any event, there is now evidence from so many cities of varying location, size, and demographics that the question of whether clean indoor air ordinances affect restaurant revenues—adversely or otherwise—should be considered closed. Local officials can now go about their business of protecting the public from the toxins in secondhand smoke without worrying about this phony issue.

Figure 1

CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION

PHILIP MORRIS, INC. GRAPH

Dolphin Group, Inc.

Calif. Business and Restaurant Alliance

PM Direct Communication

San Diego Tavern And Restaurant Assoc.

Northern Calif. Tavern and Restaurant

California Action Plan

Element 1

Point of Sale Protection Program

Element 2

AB 13 Restaurant Accommodation Program

Element 3

California Tavern Association

Figure 1. Organization chart prepared by the Dolphin Media Group, a California Public Relations firm, probably for Philip Morris Tobacco, describing planned efforts to fight implementation of California's smoke-free workplace law, AB13, which also includes restaurants and bars. This chart clearly shows that "organizations" such as the California Business and Restaurant Alliance, San Diego Tavern and Restaurant Association, and Northern California Tavern and Restaurant Association are creations of the tobacco industry. Such organizations seek to appear to be legitimate representatives of the business, community (as opposed to the tobacco industry) when dealing with the public, the press, and legislators.

Appendix 1

Cities and Counties with Ordinances Restricting Smoking in Restaurants or Bars that Have Been Studied Based on Sales Tax Data

Amherst, MA

Anderson, CA

Andover, MA

Arlington, MA

Aspen, C0

Attleboro, MA

Auburn, CA

Bedford, MA

Bellflower, CA

Belmont, MA

Beverly Hills, CA

Brookline, MA

Buncombe County, NC

Chicopee, MA

Colfax, CA

Contra Costa County, CA

Craven County, NC

Culver City, CA

Davis, CA

East Longmeadow, MA

Easthampton, MA

El Cerrito, CA

Flagstaff, AZ

Foxborough, MA

Framiugham, MA

Grass Valley, CA

Greenfield, MA

Halifax County, NC

Holden, MA

Holyoke, MA

Indian Wells, CA

Lariesborough, MA

Lee, MA

Lenox, MA

Lexington, MA

Lodi, CA

Long Beach, CA

Longmeadow, MA

Los Gatos, CA

Martinez, CA'

Medfield, MA

Mesa, AZ

Montague, MA

New York, NY

Northampton, MA

Norwell, MA

Orange County, NC

Palo Alto, CA

Paradise, CA

Plainville, MA

Plymouth, MA

Rancho Mirage, CA

Reading, MA

Redding, CA

Roseville, CA

Ross, CA

Sacramento, CA

San Luis Obispo, CA

San Joaquin County, CA

San Mateo County, CA

Santa Clara County, CA

Sharon, MA

Shasta County, CA

Snowmass, CO

South Hadley, MA

Southampton, MA

Stockbridge, MA

Stockton, CA

Sunderland, MA

Sunnyvale, CA

Telluride, CO

Tewksbury, MA

Tiburon, CA

Tracey, CA

Wake County, NC

Wakefield, MA

Walnut Creek, CA

West Springfield, MA

West Lake Hills, TX

Yountville, CA

Stanton A. Glantz, PhD, is a Professor of Medicine at the Institute for Health Policy Studies and Department of Medicine, University of California, San Francisco, California.

This work was supported in part by National Cancer Institute grant CA-61021 and a gift from Edith and Henry Everett.